BACKGROUND: Iron deficiency anemia (ICD -11:3A00, ISMT-4.7.40)) is a significant public health problem that occurs worldwide in both developed and developing countries. In 1980, the World Health Organization (WHO) estimated that 700 million people worldwide suffered from anemia and more than two billion people worldwide have been affected by it. Approximately 50% of anemia cases are caused by iron deficiency.  Iron deficiency anemia (IDA) is the most frequent hematological disorder of childhood and adolescence and the most common form of anemia, with an incidence in industrialized countries of 20.1% between 0 and 4 years of age and 5.9% between 5 and 14 years (39 and48.1% in developing countries) . It is a hypochromic and microcytic anemia characterized by Hb values below the normal range for sex and age, reduced MCV, and MCH. Iron is an essential nutrient for the development of the fetus, infant, and child . The body’s iron content is dependent on its intake and absorption with nutrition. The homeostasis of this nutrient is determined by the balance between its uptake and release from the cells where it is stored and recycled . Iron is released into the circulation where it is carried by the plasma protein transferrin, into the duodenum by enterocytes that absorb dietary iron, and by macrophages which recycle senescent erythrocytes and liver reserves. If iron levels in the body are inadequate, its intestinal absorption is enhanced [6]; In case of excess, it is stored in the enterocytes as ferritin and the liver, spleen, and bone marrow as hemosiderin. The release of free iron ions in the plasma, essential for the maintenance of its homeostasis, is mediated by ferroportin, whose expression is subordinated to the activity of hepcidin. WHO criteria for diagnosis of IDA: Age 6 months - 6 yrs: less than 11 gms, Age 6 yrs - 14 yrs : less than 12 gms. Mild: Hemoglobin 10.0 g/dL to lower limit of normal. Moderate: Hemoglobin 8.0 to 10.9 g/dL. Severe: Hemoglobin 6.5 to 7.9 g/dL. According to the Siddhar Yugi muni the diseases are widely classified into 4448 including Veluppu noi also. The term Veluppu denots the pallor of the body. Veluppu is described as a diseased condition in which the nature of the body including nail beds and conjunctiva becomes pallor. As per siddha concept Veluppu noi occurs due to excessive intake of salt and sour taste,fever, vomiting, diarrhoea, worms, liver diseases and intake of unconsumed items such as soil,ash and camphor. Iron deficiency causes different abnormalities in the three major population groups that are at risk. In iron-deficient infants and children, there is convincing evidence of impaired psychomotor development and cognitive.I have chosen siddha herbal formulation –Manjal noi kudineer contains Keezhanelli (Phyllanthus amarus,Shum&Thonn), karisalai (Eclipta prostrata,Linn), peipudal (Trichosanthes cucumerina,Linn), venmilagu (Piper cubeba,Linn), Sombu (Foeniculum vulgare,Mill), vilvam (Aegle marmelos,Linn). OBJECTIVE: PRIMARY OBJECTIVE: • To evaluate the efficacy of Manjal noi kudineer in the management of Paandu noi (IDA) in paediatric population.

OBJECTIVE: PRIMARY OBJECTIVE: • To evaluate the efficacy of Manjal noi kudineer in the management of Paandu noi (IDA) in paediatric population.

STUDY DESIGN: This is an interventional study of Non randomized sampling which will be carried out for 18 months in patients with hemoglobin level of 8.0-10.9 gm  reporting at OPD of Ayothidoss Pandithar Hospital , National Institute Of Siddha, Chennai-600047 with 30 patients as sample size. Patient with age 3-12 years of both sex.

 OUTCOME: PRIMARY OUTCOME:- • Primary outcome of the clinical study will be assessed by increase of hemoglobin (Hb) level in before &after treatment. • For clinical significance defined as the MCID of hemoglobin (Hb) increase from the baseline. SECONDARY OUTCOME: Reduction of clinical symptoms like malaise, headache, palpitation, lack of concentration during before and after treatment.

RESULT AND DISCUSSION: The result will be statistically analysed and reported.

KEYWORDS: anemia, manjal noi kudineer, hemoglobin.